6YS-19725-75705

3 vaccinations 12 coded responses 24 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 303 / GA
Registered: 2021-03-25

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-24
Dose 1 — Moderna
2021-03-25
Registered in v-safe
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Peripheral coldness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Left arm cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Survey response — day 14, dose 1
MedDRA: Asthenia, Hypoaesthesia — Feeling: Fair

Free text: When Iam out in the sun ,it drains all my energy, it take almost two days to recovery. I know that it's the shot,because it's the only difference, also my fingers and toes still get numb.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-21
Dose 2 — Moderna
2021-04-21
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Light headiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Musculoskeletal stiffness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Light headness and stiffness in back and shoulders

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal stiffness, Neck pain, Spinal pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Neck and spine stiff and lot of pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Feeling abnormal — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Foggy brain,confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Numbness in both legs and neck,shoulders

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Pain in extremity, Peripheral coldness — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Numbness of the feet ,very cold knees and pain in feet and legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 7, dose 2
MedDRA: Eye pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Pain in back of my eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-05-12
Health check-in — day 21, dose 2
Feeling: Poor

Adult check-in
2021-05-19
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-06-02
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-01
Dose 3 — Moderna
2022-04-21
Survey response — 12 months, dose 2
MedDRA: Pain in extremity — Feeling: Fair

Free text: Pain in both upper arms at random times

MedDRA releases: 2024-11 · check-in free text available
2023-01-01
Survey response — 12 months, dose 3
MedDRA: Headache, Rhinorrhoea — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-21	Moderna
3	2022-01-01	Moderna	No

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): Left arm cold

2021-03-26

Systemic reaction (other): Sore throat

Release 7 — day 14, dose 1

2021-04-07

Symptoms: When Iam out in the sun ,it drains all my energy, it take almost two days to recovery. I know that it's the shot,because it's the only difference, also my fingers and toes still get numb.

Release 7 — day 0, dose 2

2021-04-21

Systemic reaction (other): Light headiness

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Light headness and stiffness in back and shoulders

2021-04-24

Systemic reaction (other): Neck and spine stiff and lot of pain

2021-04-25

Systemic reaction (other): Foggy brain,confusion

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Numbness in both legs and neck,shoulders

2021-04-27

Systemic reaction (other): Numbness of the feet ,very cold knees and pain in feet and legs

Release 8 — day 7, dose 2

2021-04-28

Systemic reaction (other): Pain in back of my eyes

Release 11 — 12 months, dose 2

2022-04-21

Symptoms: Pain in both upper arms at random times

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
SD	Asthenia	✓	✓	✓
SD	Headache	·	·	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Confusional state	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Spinal pain	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release